13 November 2014

India doctor arrested, denies role in women deaths

The doctor who conducted sterilization procedures after which 13 women died in central India was arrested, but insisted he didn't do anything wrong — even though he said he used to perform up to 10 times more surgeries a day than allowed.

Dr. R.K. Gupta, who had been hiding since Saturday's operations, was arrested at a relative's home near Bilaspur city late Wednesday, said Dr. S.K. Mandal, the chief medical officer of Chhattisgarh state.

Gupta denied responsibility for the deaths and blamed medication given to the women after the surgeries.

A total of 83 women had the surgeries as part of a free government-run mass sterilization campaign and were sent home that evening. But dozens became ill and were rushed in ambulances to private hospitals in Bilaspur.

Mandal said at least 13 women died and dozens more were hospitalized, including at least 16 who are fighting for their lives.

Gupta had performed the 83 surgeries in six hours — a clear breach of government protocol, which prohibits surgeons from performing more than 30 sterilizations in a day, Mandal said. He said investigators were also trying to determine whether the women, all of them poor villagers, had been given tainted medicines.

"I am not guilty. I have been performing surgeries for a long time and there has never been any problem," Gupta told reporters in Bilaspur around the time of his arrest.

"I have a history of completing up to 200-300 surgeries in one day," he said. "There are no written guidelines, but what we have been told verbally is that we shouldn't perform more than 30 operations in a day."

He said the patients began throwing up and complaining of dizziness and weakness after they were given medication following the operations.

Gupta has been charged with culpable homicide not amounting to murder, local Inspector General of Police Pawan Dev told the Press Trust of India news agency. If found guilty he would face a maximum punishment of life in prison.

Experts say the deaths are the result of a lack of medical oversight and because of sterilization targets set by the Indian government as part of its efforts to stabilize the country's booming population.

In the 1970s, Prime Minister Indira Gandhi imposed a policy of forcibly sterilizing men who had already fathered two children. Opponents said the program targeted unmarried and poor men, with doctors given bonuses for operating on low-income patients.

India's government said it stopped setting targets for sterilizing women in the 1990s. But doctors and human rights workers have alleged for years that targets exist, which would lead to inevitable coercion in villages where most people have limited access to education and health care.

Mandal said earlier that Gupta was likely under pressure to achieve his district's target of about 15,000 sterilizations.

In January, Gupta was feted by the state government for performing 50,000 laparoscopic tubectomies.

Sterilizations continue to be the most popular method of birth control in India, with many women opting for them because a one-time operation can help them take charge of their fertility.

But incentives and government quotas cause doctors to pressure patients into surgery rather than advising them on other contraception options.

Women in most Indian states are promised 1,400 rupees ($23) when they choose to have laparoscopic, or "keyhole," sterilization surgeries like those conducted in Bilaspur. The procedure is one of the most commonly performed minimally invasive surgeries, and is usually done under a local anesthetic.

The relatives of some of the women who died said they were bullied into getting the surgery. Most of the women had very young babies, some of whom were still breastfeeding.

"I hope that he can never sleep in peace," said Sadhu, the husband of one woman who died after the operation. "The same thing should happen to him. Then he will know what it is like to lose someone in your family."

India has one of the world's highest rates of sterilizations among women, with about 37 percent undergoing such operations compared with 29 percent in China, according to the United Nations. About 4.6 million Indian women were sterilized in 2011 and 2012, according to the government.

In comparison, less than 1 percent of men choose to undergo vasectomies even though the cash incentive is higher at about 2,000 rupees ($33). Cultural taboos inhibit men from opting for the operation.